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News by Topic: Health insurance

Apr 14, 2026 - Notice of proposed rule from the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) proposing to improve the electronic exchange of healthcare data and streamline processes related to prior authorization by increasing the interoperability of systems used across the healthcare industry. Among other things, this rule proposes new requirements for Medicare Advantage (MA) organizations, state Medicaid fee-for-service (FFS) programs, state Children's Health Insurance Program (CHIP) FFS programs, Medicaid managed care plans, CHIP managed care entities, and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs) to make electronic prior authorization for drugs available; to report their application programming interfaces (API) endpoints and related information for the Patient Access, Provider Directory, Provider Access, Payer-to-Payer, and Prior Authorization APIs to CMS; and extend many existing interoperability requirements for the prior authorization of non-drug items and services to include prior authorizations for drugs. In addition, ONC proposes adopting updated versions of certain health information technology (health IT) standards and specifications for HHS use. Comments are due by June 15, 2026.
Source: Federal Register
Apr 14, 2026 - Notice of a proposed rule from the Centers for Medicare & Medicaid Services (CMS) regarding changes to the hospital inpatient prospective payment system (IPPS) for operating and capital-related costs of acute care hospitals for fiscal year 2027. Contains details of proposed changes related to Medicare graduate medical education (GME) for teaching hospitals; payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals; and certain quality programs, among other things. Comments are due by April 10, 2026.
Source: Federal Register
Apr 14, 2026 - Notice from the Centers for Medicare and Medicaid Services (CMS) of a hybrid public meeting on June 1-2, 2026, to discuss the preliminary coding, Medicare benefit category, and Medicare payment determinations for new revisions to the Healthcare Common Procedure Coding System (HCPCS) Level II code set. The agenda and information on how to join the meeting will be posted on the CMS website. Registration is required for in-person attendees.
Source: Federal Register
Apr 9, 2026 - Announcement from the Centers for Medicare & Medicaid Services (CMS) of receipt of an application from DNV Healthcare Inc. for continued recognition as a national accrediting organization for hospitals that wish to participate in the Medicare or Medicaid programs. Comments are due by May 11, 2026.
Source: Federal Register